Healthcare Provider Details

I. General information

NPI: 1437629169
Provider Name (Legal Business Name): TOTAL CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2018
Last Update Date: 11/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 PHILADELPHIA WAY STE J
LANHAM MD
20706-4450
US

IV. Provider business mailing address

5000 PHILADELPHIA WAY STE J
LANHAM MD
20706-4450
US

V. Phone/Fax

Practice location:
  • Phone: 301-918-0070
  • Fax:
Mailing address:
  • Phone: 301-918-0070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: RICARDO LYLES
Title or Position: DIRECTOR OF BUSINESS DEVELOPMENT
Credential: DO
Phone: 301-918-0070